An excluded provider is one who is barred from participation in Medicare and/or other healthcare programs, like Medicaid, due to program violations. An excluded provider is not entitled to bill or be reimbursed for medical services provided to any federal or state healthcare program beneficiary. DHHS works diligently to prevent excluded providers from participating in NC Medicaid and NC Health Choice to comply with federal regulations.
The North Carolina Medicaid Provider Termination and Exclusion list is updated monthly. The termination or exclusion is in effect until the provider is removed from this list.
The U.S. Department of Health and Human Services Office of the Inspector General maintains a national list of all individuals excluded from receiving Medicare and Medicaid reimbursement.